Short Communication - (2021) Volume 6, Issue 2
Fungal dysbiosis in cirrhtic patients due to the use of antimicrobials. Risk or benefit
2General Medical University Foundation of Health Sciences, Bogota, Colombia
3General Medical Libre University Of Barranquilla, Colombia
4Intern At The University of Sinú, Monteria, Colombia
5Intern At The University of Sinu, Monteria, Colombia
6Intern At The University of Sinu, Monteria, Colombia
7Intern At The University of Sinu, Monteria, Colombia
8General Medical Libre University of Barranquilla, Colombia
Received Date: Jul 12, 2021 / Accepted Date: Jul 20, 2021 / Published Date: Jul 28, 0202
Copyright: ©Lina Marcela Ortiz Roncallo, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation: Lina Marcela Ortiz Roncallo., Carlos Andres Perez Lozano., Adalberto Ruiz Ballesta., Silvia Juliana Rodriguez Perez., Amaury Gustavo Lopez Agamez., et al. (2021). Fungal dysbiosis in cirrhtic patients due to the use of anti-microbials Rick or benefit?, Adv Nutr Food Sci, 6(2), 22-24.
Abstract
There is a significantly marked fungal dysbiosis in cirrhotic patients, which changes differentially with the use of antibiotics and proton pump inhibitors, although it is known that patients with cirrhosis have a fairly weakened immune system, therefore, these have a greater risk of developing bacterial infections, the use in this type of patients of drugs such as proton pump inhibitors and antimicrobials, represents an even greater risk of developing, no longer bacterial infections, but of fungal origin [1].
Introduction
There is a significantly marked fungal dysbiosis in cirrhotic pa-tients, which changes differentially with the use of antibiotics and proton pump inhibitors, although it is known that patients with cirrhosis have a fairly weakened immune system, therefore, these have a greater risk of developing bacterial infections, the use in this type of patients of drugs such as proton pump inhibitors and antimicrobials, represents an even greater risk of developing, no longer bacterial infections, but of fungal origin [1].
Although, the above should not be seen as an even worse problem, since various studies, among which an investigation carried out during 90 days in 26 healthy control patients and 143 patients with cirrhosis, of which 47 presented an infection treated with antibi-otic therapy. The analysis made revealed that bacterial and fungal diversities were significantly related and that this association de¬creased markedly in case of infection. On the other hand, these dysbiosis were accentuated as the clinical state worsened until reaching terminal liver failure. This showed that fungi represent an important point in intestinal dysbiosis, being able to be used as a predictive marker for the risk of hospitalization in cirrhotic patients and even as therapeutic measures [2].
However, on the other hand, a study concluded that intestinal fun¬gi can contribute to the development of alcoholic liver disease, scientists from the University of California who carried out this research, used a mouse model and human samples of serum and stool obtained from healthy patients and patients with liver dis¬eases, through this study they were able to observe that patients with alcohol dependence showed a reduction in the diversity of intestinal fungi and an excessive growth of candida. However, on the other hand, a study concluded that intestinal fungi can contrib¬ute to the development of alcoholic liver disease, scientists from the University of California who carried out this research, used a mouse model and human samples of serum and stool obtained from healthy patients and patients with liver diseases, through this study they were able to observe that patients with alcohol depen¬dence showed a reduction in the diversity of intestinal fungi and an excessive growth of candida [3].
As in cirrhosis, the intestinal microbiota is involved in the course of other liver pathologies, in fact, numerous investigations have indicated that the intestinal microbiota and Toll-like receptors promote the development of hepatocarcinoma [4]. In the litera¬ture, the pathophysiological process is attributed to the fact that lipopolysaccharides and the molecular patterns associated with the pathogen, products of intestinal bacteria, activate TLR4, thus triggering signals that stimulate the Nuclear Factor KB cascade, which results in greater epiregulin secretion, increasing with it pro-inflammatory cytokines and inflammatory molecules such as tumor necrosis factor, thus initiating the development of hepato¬carcinoma [5].
It is for this reason that various authors have suggested the use of antibiotics, since these could prevent the development of hepato¬carcinomas in patients with liver disease [5]. To conclude, I would advise carrying out more research in order to know the background of intestinal dysbiosis both at the level of bacteria and fungi, since as we can see on the one hand the use of antimicrobials would affect the microbiota and could trigger disorders but on the oth¬er hand, its use would be related to reducing the development of hepatocarcinomas, it is at this point that we would have to assess whether the risk is less than the benefit or we are facing a Trojan horse that has a more significant impact on patients cirrhotic.
References
- Bajaj, J. S., Liu, E. J., Kheradman, R., Fagan, A., Heuman, D. M., White, M., ... & Gillevet, P. M. (2018). Fungal dysbiosis in cirrhosis. Gut, 67(6), 1146-1154.
- Muñoz, L., Borrero, M. J., Úbeda, M., Conde, E., Del Campo, R., Rodríguezâ?ÂÂSerrano, M., ... & Albillos, A. (2019). Intestinalimmune dysregulation driven by dysbiosis promotes barrier disruption and bacterial translocation in rats with cirrhosis. Hepatology, 70(3), 925-938.
- Bajaj, J. S., Vargas, H. E., Reddy, K. R., Lai, J. C., O’leary,J. G., Tandon, P., ... & Gillevet, P. M. (2019). Association between intestinal microbiota collected at hospital admission and outcomes of patients with cirrhosis. Clinical Gastroenter-ology and Hepatology, 17(4), 756-765.
- Ciocan, D., Voican, C. S., Wrzosek, L., Hugot, C., Rainteau, D., Humbert, L., ... & Perlemuter, G. (2018). Bile acid homeostasis and intestinal dysbiosis in alcoholic hepatitis. Alimenta-ry pharmacology & therapeutics, 48(9), 961-974.
- Zeng, Y., Chen, S., Fu, Y., Wu, W., Chen, T., Chen, J., ... & Ou,Q. (2020). Gut microbiota dysbiosis in patients with hepatitis B virus–induced chronic liver disease covering chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Journal of viral hepatitis, 27(2), 143-155.